A risk assessment scale for the prediction of pressure sore development: reliability and validity

Background. The ability to assess the risk of a patient developing pressure sores is a major issue in pressure sore prevention. Risk assessment scales should be valid, reliable and easy to use in clinical practice. Aim. To develop further a risk assessment scale, for predicting pressure sore development and, in addition, to present the validity and reliability of this scale. Methods. The risk assessment pressure sore (RAPS) scale, includes 12 variables, five from the re-modified Norton scale, three from the Braden scale and three from other research results. Five hundred and thirty patients without pressure sores on admission were included in the study and assessed over a maximum period of 12 weeks. Internal consistency was examined by item analysis and equivalence by interrater reliability. To estimate equivalence, 10 pairs of nurses assessed a total of 116 patients. The underlying dimensions of the scale were examined by factor analysis. The predictive validity was examined by determination of sensitivity, specificity and predictive value. Results. Two variables were excluded as a result of low item–item and item–total correlations. The average percentage of agreement and the intraclass correlation between raters were 70% and 0·83, respectively. The factor analysis gave three factors, with a total variance explained of 65·1%. Sensitivity, specificity and predictive value were high among patients at medical and infection wards. Conclusions. The RAPS scale is a reliable scale for predicting pressure sore development. The validity is especially good for patients undergoing treatment in medical wards and wards for infectious diseases. This indicates that the RAPS scale may be useful in clinical practice for these groups of patients. For patients undergoing surgical treatment, further analysis will be performed.måsjekke

In the vulnerable room. : Nurses’ experiences and challenges in the meeting with overweight children and their parents.

Titel: I det känsliga rummet - Sjuksköterskors erfarenheter och upplevda utmaningar i mötet med överviktiga barn och deras föräldrar. Bakgrund: Barns övervikt och fetma är idag ett globalt och ökande problem. Att utveckla en övervikt som barn innebär en mängd olika riskfaktorer, som kan följa med även i vuxen ålder. Sjuksköterskor inom barnhälsovården når i princip alla barn och spelar därför en betydande roll i arbetet med detta folkhälsoproblem. Syfte: Syftet med studien var att beskriva sjuksköterskors erfarenheter och upplevda utmaningar i mötet med överviktiga barn och deras föräldrar. Metod: En litteraturstudie uppbyggd på tio stycken kvalitativa, vetenskapliga artiklar. Resultat: Resultatet presenteras i fyra huvudkategorier: “Betydelsen av kommunikation”, “Samhälleliga aspekter”, “Sjuksköterskans roll” och “Familjens betydelse”. Konklusion: Övervikt och fetma upplevs vara ett svårt ämne att tala om och sjuksköterskor kämpar med hur de ska förmedla budskapet på rätt sätt. Sjuksköterskor uttrycker ett stort behov av mer tid och fler resurser och ifrågasätter sina egna kunskaper om ämnet. Kulturella olikheter och samhällets förändring av normer utgör hinder för sjuksköterskor och påverkar deras arbete. En god relation med familjen ligger till grund för att kunna motivera och påverka familjen till en hälsosammare livsstil. Title: In the vulnerable room: Nurses’ experiences and challenges in the meeting with overweight children and their parents.   Background: Children’s overweight and obesity is a global and increasing problem. The development of an overweight as a child comes with a number of risk factors that can persist into adulthood. Nurses within the child health care reaches almost all children and therefore play an important role in the work with this public health problem.   Aim: The aim of the study was to describe nurses’ experiences and challenges in the meeting with overweight children and their parents.   Method: A literature study based on ten qualitative, scientific articles.   Result: The result is presented in four main categories: “The importance of communication”, “Societal aspects”, “The nurse’s role” and “The importance of the family”.   Conclusion: Overweight and obesity are perceived as difficult subjects to approach and nurses are struggling with how to convey the message in an appropriate way. Nurses are expressing a big need for more time and more resources and are questioning their own skills about the subject. Cultural differences and the society’s change of norms are seen as barriers and affect the nurses work. A good relationship with the family is described as one of the most important aspects in order to get the family motivated to a healthier lifestyl

Innate immune recognition of bacterial ligands by NAIPs determines inflammasome specificity

Inflammasomes are a family of cytosolic multiprotein complexes that initiate innate immune responses to pathogenic microbes by activating the caspase 1 protease. Although genetic data support a critical role for inflammasomes in immune defence and inflammatory diseases, the molecular basis by which individual inflammasomes respond to specific stimuli remains poorly understood. The inflammasome that contains the NLRC4 (NLR family, CARD domain containing 4) protein was previously shown to be activated in response to two distinct bacterial proteins, flagellin and PrgJ, a conserved component of pathogen-associated type III secretion systems. However, direct binding between NLRC4 and flagellin or PrgJ has never been demonstrated. A homologue of NLRC4, NAIP5 (NLR family, apoptosis inhibitory protein 5), has been implicated in activation of NLRC4 (refs 7-11), but is widely assumed to have only an auxiliary role, as NAIP5 is often dispensable for NLRC4 activation. However, Naip5 is a member of a small multigene family, raising the possibility of redundancy and functional specialization among Naip genes. Here we show in mice that different NAIP paralogues determine the specificity of the NLRC4 inflammasome for distinct bacterial ligands. In particular, we found that activation of endogenous NLRC4 by bacterial PrgJ requires NAIP2, a previously uncharacterized member of the NAIP gene family, whereas NAIP5 and NAIP6 activate NLRC4 specifically in response to bacterial flagellin. We dissected the biochemical mechanism underlying the requirement for NAIP proteins by use of a reconstituted NLRC4 inflammasome system. We found that NAIP proteins control ligand-dependent oligomerization of NLRC4 and that the NAIP2-NLRC4 complex physically associates with PrgJ but not flagellin, whereas NAIP5-NLRC4 associates with flagellin but not PrgJ. Our results identify NAIPs as immune sensor proteins and provide biochemical evidence for a simple receptor-ligand model for activation of the NAIP-NLRC4 inflammasomes

Parasitas gastrointestinais e externos do tico-tico Zonotrichia capensis (Passeriformes, Emberizidae) do Chile

A total of 277 rufous-collared sparrows, Zonotrichia capensis Müller, 1776 (Emberizidae), were examined for external parasites. The birds were captured using mist nets in seven locations in northern and central Chile. Additionally, seven carcasses from central Chile (the Biobío region) were necropsied to evaluate the presence of endoparasite infection. Ectoparasites were found on 35.8% (99/277) of the examined birds and they were represented by the following arthropods: feather mites Amerodectes zonotrichiae Mironov and González-Acuña, 2014 (Analgoidea: Proctophyllodidae), Proctophyllodes polyxenus Atyeo and Braasch, 1966 (Analgoidea: Proctophyllodidae), and Trouessartia capensis Berla, 1959 (Analgoidea: Trouessartiidae); a louse Philopterus sp. (Phthiraptera: Ischnocera); and ticks Amblyomma tigrinum Koch, 1844 (Acari: Ixodidae) and Ixodes auritulus Neumann, 1904 (Acari: Ixodidae). Two of the seven necropsied carcasses were infected with the acanthocephalan Mediorhynchus papillosus Van Cleave, 1916 (Gigantorhynchida: Gigantorhynchidae). To our knowledge, this study reports P. polyxenus, Philopterus sp., A. tigrinum, and M. papillosus for the first time for Z. capensis and expands the distributional range for T. capensis to Chile.Um total de 277 tico-tico Zonotrichia capensis Müller, 1776 (Emberizidae) foram examinados em busca de ectoparasitos. As aves foram capturadas com redes em sete localidades do norte e centro do Chile. Além disso, sete carcaças do centro Chile (Região de Biobío) foram examinadas para avaliar a infecção por endoparasitos. Ectoparasitos foram encontrados em 35,8% (99/277) das aves examinadas com a identificação dos ácaros Amerodectes zonotrichiae Mironov and González-Acuña, 2014 (Analgoidea: Proctophyllodidae), Proctophyllodes polyxenus Atyeo and Braasch, 1966 (Analgoidea: Proctophyllodidae) e Trouessartia capensis Berla, 1959 (Analgoidea: Trouessartiidae), piolho Philopterus sp. (Phthiraptera: Ischnocera) e carrapatos Amblyomma tigrinum Koch, 1844 (Acari: Ixodidea) e Ixodes auritulus Neumann, 1904 (Acari: Ixodidea). Duas das sete carcaças examinadas foram infectadas com o Acantocephala Mediorhynchus papillosus Van Cleave, 1916 (Gigantorhynchida: Gigantorhynchidae). Para o nosso conhecimento, este é o primeiro estudo para descrever P. polyxenus, Philopterus sp., A. tigrinum e M. papillosus em Z. capensis e expande a distribuição de T. capensis ao Chile.Fil: Llanos Soto, Sebastián. Universidad de Concepción; ChileFil: Muñoz, Braulio. Universidad de Concepción; ChileFil: Moreno, Lucila. Universidad de Concepción; ChileFil: Landaeta Aqueveque, Carlos. Universidad de Concepción; ChileFil: Kinsella, John Mike. Helmwest Laboratory;Fil: Mironov, Sergey. Russian Academy Of Sciences;Fil: Cicchino, Armando Conrado. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones en Biodiversidad y Biotecnología. Grupo de Entomología Edáfica Bonaerense Suboriental - GENEBSO; ArgentinaFil: Barrientos, Carlos. Universidad Santo Tomas; ColombiaFil: Torres Fuentes, Gonzalo. Universidad de Concepción; ChileFil: González Acuña, Daniel. Universidad de Concepción; Chil